Chapter 4
Orphanage Life
Most of the children who are adopted internationally have spent a large portion of their lives in orphanages. Some have been exclusively in foster care but this experience in not common in most countries. The impact of orphanage life on your child will depend on many factors. Your child’s life experiences before entering the orphanage, the level of care they receive, caretaker to child ratio, length of time in the orphanage, the child’s medical needs and the culture in which he/she was raised will all influence the child. Some orphanages offer wonderful care provided by loving caretakers in a clean, neat setting. In contrast, other institutions are very sparse in their physical setting and may have little supervision for the children. There is no way to predict what your child’s experience will be at this time so we will cover orphanage life in general and begin to explore the life long impacts of institutionalization on your child.
Child rearing techniques are culturally based and the orphanage is a subset within the larger culture. It is important for you as a prospective adoptive parent to be as informed as possible on how this is likely to influence your child. This chapter will begin to address some of the issues. As with the other chapters, we encourage you to do your own research on adoption related issues to augment what you learn here and learn as much as you can about the country of your child’s origin.While some children have had the experience of living with a functional family, most children have not had that experience. Just like in this country, there are reasons why an adoption plan is made for a child. The reasons will vary. Even after getting some information on your child, it may not be totally clear as the “referral” may offer little background information. Unlike in this country a birth mother is not usually counseled and does not provide much, if any, information about herself. Most often that information is not gathered for the child you will be adopting. You may never know the whole reason for your child’s availability. Often the reason is economic in nature, but the reasons are as varied as the people who have made the difficult choice to not parent their children. This is why we encourage you to have the information you obtain evaluated by a professional who is well versed in international adoption (discussed more in Chapter 5). It is important for you to be realistic in your expectations and knowledgeable in how to address the inevitable concerns that will come with your child.
For some children, an adoption plan was made shortly after birth. Some of these children may have had multiple settings and caretakers. For instance, children can spend months at the hospital after birth because there is no room at the orphanage. For people who visit orphanages, there is a perception that there are lots of children there so they are left with the question of why it took so long for them to be referred a child. What potential adoptive families need to keep in mind is that many, if not most of these children, are not legally free for adoption. In many countries, the orphanage also functions as their foster care system, so the children you see may have families and will never be referred for adoption. There is a complex set of requirements that each country, region and/or orphanage has in order to assure that the child is indeed legally available.
In Russia, one of the steps you will need to know about is the Data Bank. The children are listed there for a specified amount of time (two months in some regions, six in others). Only when they have met the requirement can they be considered by parents from other countries. The purpose of this Data Bank is to encourage local adoptions. The number of Russian couples who are adopting is rising. Sometimes when adoptive families go to meet with the child they have been invited to see, they want to take pictures of other children and find homes for them. That is not how it works, however, in that the children may not be legally available. Since the Ministry of Education is in charge of the children in Russia, the local Departments of Education are given the authority to make the decisions of which child will be referred and in order to refer a child, the child has to be legally available. Some of the children in the orphanage are there for “foster” care and will never be available for adoption. It is imperative to realize that it is the country and their legal processes determine the availability of the children. Please research the process in your chosen country. Situations and protocols change frequently.
Some countries offer a combination of orphanage care and foster care. Others will place the children in foster care as a general rule while many rely mainly on orphanages. One of the things your case manager will discuss with you is the system more specific to your country selection.
Your child will present cultural and developmental differences peculiar to his/her age and experience in the country of origin. We encourage you to learn as much as you can about your child’s country as possible. The things you learn by reading and traveling to your child’s country of origin will help immeasurably in aiding your child's understanding his/her circumstances. Absorb as much as you can. Read a lot, take lots of pictures, write a journal, do all you can to understand and appreciate your experience as it will help you present this information in a favorable, respectful and loving light to your child.
Some people ask what the chances are that their child will be “normal” upon arrival home. The answer is essentially zero. Developmental delays, attachment issues and poor physical growth are all to be expected. Orphanages are not the ideal place for a child. Lack of stimulation, inconsistency in caretakers, lack of individual attention, less than optimal nutrition and medical issues are frequent. This information is not included to scare you. The preponderance of families when queried responded that they would adopt again if they were to go back. However, knowing the risks and possibilities beforehand will aid you in addressing the issues your child will present.
Many families ask for a healthy child. While this is certainly understandable, it is imperative to enter international adoption with your eyes wide open. While many of these children achieve good general health, the mere factors in the child’s existence assure that the child will have medical, emotional and developmental concerns – at least in the beginning. If the children had all their needs met, there would be no need for international adoption. According to the latest research, about 98% of adoptive parents would, if given the chance, to go back and do it again. Being satisfied with their decision does not mean that the children were problem free (but then again, whose children are?) but they love their children with all the passion and depth that is present for those who parent through birth. This is good news for you. While international adoption brings challenges, it also brings great joys and satisfaction.
There is no way to “order” a child. Some adoptive parents come into adoption expressing the desire for a child who fits specific criteria in terms of looks, health, intellectual potential and even eye and hair color. While adoption agencies strive to meet as many of these as possible to make the “best” match, coming into this decision with broader expectations will help facilitate a smoother process. Be aware that there is no way that you will have all the information you need to completely eliminate risk. The best decisions you can make will be informed and well-reasoned but will inevitably be accompanied by the “leap of faith” necessary in adoption decisions.
Children raised in institutions can exhibit some confusing behaviors. On one hand, they may seem more independent than others their age as they have not been pampered and have had to take care of many of their own needs. On the other hand, they are more dependent in their ability to make decisions. They had little choices, therefore have not learned the basics of cause and effect. This is important knowledge for the new parents as they seek ways to meet the needs of their new child. Knowing your child will be the most important key to success. The ability to patiently work through the issues that come with the child will help assure the best results.
Routines are a necessary part of orphanage life. Imagine for a moment how it would be for you to care for six babies yourself. Could you consistently meet each of their needs? The best way to “do more with less” is to establish and maintain routines. Children are often fed and changed on a schedule. If a child is hungry and wants his bottle, he may have to wait until the two children ahead of him get theirs. Some caretakers are phenomenal and are very affectionate, while others are tired and overworked. This will affect the level of care that a child will receive.
The first task that a baby has is to learn to trust the world. That task is met through consistent provision for the child’s needs. When the child is hungry, someone comes to provide food and when the child is wet, someone comes to change the child. If that has not been done, the basic sense of trust may not have been achieved. Certainly, when you begin to parent your new child, you will need to provide the same types of care. The child will need to have you consistently meet their basic needs in order to establish trust in you. For example, many institutionalized children will horde food (even babies will eat until you think they may explode). This behavior will generally diminish as the child comes to realize that there will be food available to meet his/her needs. Children will develop more appropriate skills when they learn to trust that their basic needs will be met.Some children display behaviors that are disconcerting to many new parents. They might rock back and forth when tired, agitated, or nervous. It is not a surprise that children develop ways to take care of themselves when they needed a hug and they did not get one. Now, however, they will not need that particular skill as they learn to trust that when they are tired or lonely, someone will be the parent and hold them, rock them, etc. Some children do not relinquish their role easily, however, and may not welcome immediate closeness, they are not used to it. In this case, new parents need to not take it personally or see it as a rejection of them. It is not about the parents and whether they are good people. It is about the child and their need to control their environment to feel safe.
Some of these children do not ask for help even when they need it and you will need to watch them closer. They may be quite creative in devising their own interpretation of how to get the job done. As they learn that they do not need to parent themselves or solve all of their own problems, they can relax allow someone else to parent them.
Some children have difficulty moving from one activity to another and will display what is called “poor transitions.” Others may become easily over-stimulated. Certainly just being in their new home will be very stimulating for a child. They have a whole new set of rules, routines, food and expectations. Everything in their lives needs to be renegotiated. They can become hyper-vigilant and may not be able to relax easily.
Sleep is difficult for some children. Most orphanages have low light at night because the caregivers need to see how the children are doing without awakening them. Therefore, having a night-light on in their room often comforts children. Sleeping alone is difficult for many children as they are used to sleeping in rooms with multiple children. Babies may have shared a large crib with several others. This is often one of the hardest life changes new parents share with their new child. Parents may become fatigued as well as the child and this situation makes attachment harder. People who are sleep deprived have more difficulties dealing with stressful situations and in making appropriate decisions. It is best not to see this as a life long situation even though it may seem that some days seem weeks long and that you will never catch up on your sleep.
Individual needs are often not met due to time constraints on the part of the caretaker. Therefore, a child’s cries may not precipitate an immediate response to address their needs. A child may learn to cry louder and louder or, more likely, not as much as it becomes clear that it does not elicit a response. Children are often not reinforced consistently for accomplishments or for desired behaviors. Take the time to reflect on how you or other adults reinforce positive behavior and note accomplishments of the children. Observe others doing this for their children. You can learn much from observation.
Group dynamics are formed early on. As children are often stratified, siblings are often not kept together. If the oldest sibling ages out of the orphanage, he/she moves on to another facility. Some siblings have not seen each other for years and may not have an attachment. We in the United States tend to think that siblings belong together if at all possible. If that is not possible, the information about the sibling are made available so that they can establish a renewed relationship in the future if they desire. That is often not possible as formal records are not kept and relationships may be “known” by individuals in a more informal way. For example, an orphanage director may have had the older sibling in her orphanage previously. You may or may not be advised about the child’s siblings. If the officials know the information, there may be a notation that the older or younger child exists. Sometimes these children are also available for adoption but sometimes not. Some countries may decide that siblings need to be placed together while other times it is decided that they will be placed separately.
Feeding techniques conform to cultural and orphanage norms. In some countries, babies are fed with large nipples in their bottles and big holes in them. Toddlers are seen eating with tablespoons and eat quickly. If that has been your child’s experience, it is easy to see why he/she would be frustrated with a small hole in the nipple and/or a small spoon where they need to work harder to get the food they need. Sucking on the breast or bottle is an important lesson for children, one they often miss in an orphanage. Learning how to “work” to get food, to suck, to manipulate mouth and swallowing, may need to be re-learned later through sensory integration exercises. Part of what you will be doing when you first meet your child is to research and note what your child’s experience has been so that you can duplicate it during the transition period. Ask the questions if you are not able to observe it personally. It will make the child’s adjustment smoother and less traumatic.
Toilet training varies among institutions. Often, toddlers are placed on potty chairs on a scheduled basis. It is important to understand that it is highly possible that the newly adopted toddler may not really “get it” and that even if he/she does, may regress with the stresses of transition. It is advised to utilize “pull ups” or something similar during travel and/or the transition period because “accidents” may be a problem. If a child does wet the bed, it is important never to shame or punish the child. The use of a plastic sheet, training pants, night diapers and making sure that the child has gone to the bathroom directly before bed may help. Encouraging the child to drink adequate water daily is important, but limiting them directly before bedtime may help the child who is prone to bed wetting.
Schedules are not adjusted to meet the children’s individual needs. They are designed to be efficient and practical. Routines lend themselves to predictability. A child who joins your family may feel out of control and not “safe” when every day is in flux. Establishing your routines will help the child feel comfortable and the transition to your family will be smoother as your child learns to know what is expected from him/her AND from you.
Children may not have learned socially acceptable or “correct” emotions. They have to be taught these things. They need to observe signs of happiness and laughter to know where it fits in properly. Some of these children are not sure which behavior and/or emotion goes with which experience. It will take some time for your child to learn your family norms. Have patience. Help your family and friends know that if your new 5-year-old girl does not say “thank you” for the new toy, the child is not being mean. She may not have been taught this behavior or, as in most institutions, not have received gifts of things that will remain her own. Things in orphanages are mostly shared. The outfit that a child wears one day will be worn by another the next. Toys are shared. If the child did get something new to play with, it was not new for long. Children often display either a disregard for things or a need to control their new belongings. Do not be surprised if your child has some of these reactions. Gently teach them other approaches.
Caretakers come and go in their lives. Unless in a foster setting, these children have had a different set of caretakers during the day than during the night. As these positions are lower in economic standing, there is frequent turnover in the staff of many institutions. If your child has a favorite caretaker or someone who has provided extra care, he/she will be more likely to be able to bond more quickly with you. Grief and loss are experiences for these children and babies feel these emotions too. This is one area where more research on the part of the adoptive parents is needed. Take the time to explore this issue, as it is a large one for your child. The normal bonding and attachments relationships that occur in a family setting do not occur as readily in orphanage settings where protocols are set to met the needs of many children at a time. You may feel the bonding process taking place long before the child does. For many adoptive parents, there have been months if not years of planning to get to the point that they are ready to adopt. Your child has not had that time. A young child may feel kidnapped. They have suddenly been placed in a situation they may have little or no preparation for AND they did not get a vote. It will take time and effort to establish a reciprocal relationship between the child and the primary caretakers. It is important to remember that what seems normal or positive to you may seem quite foreign and strange to a child. The length of time that this attachment and bonding process will take will vary with many factors. The age of the child, the child’s individual personality, life experience, and resiliency are but a few.
Some children are very resilient and adjust to change quickly, while others are overwhelmed by any changes in routine and settings. It is vital for new parents to be aware of how their child processes these experiences and tailor the daily activities to meet the needs of the child. For the child who needs predictability, it is difficult for him/her to be spontaneous. A sudden change in plans or routine may make this child feel frightened and insecure. Your job, as the parent(s), is to ease the transition by creating a calm, gentle, loving, and predictable environment. Until the child learns to totally understand the concept of family, mother and/or father, and becomes familiar with the new world in which he or she is living, it will be most important to focus on the impacts of change.
Take some time to experience the following exercise. It will help you understand how your child may feel.
Imagine how you would feel if tomorrow a stranger came to your home and took you away from everything you had ever known. All your familiar people, stores, things, sounds, smells, language, and foods would be changed and, perhaps, lost forever. Even if the stranger is very kind and nice, this change is hard. All of your routines are changed. You will eat and sleep on a different schedule. Your whole structured, scheduled and predictable life has new changed. Perhaps our body reacts: you may have stomach problems; you may sleep sporadically or have nightmares. You feel cranky and are afraid of when the next change will happen. Your whole sense of security is gone. You wonder when the next change will happen. You feel totally out of control. You are stressed and insecure. You try to please those who are with you but are often unsure how to do that. Eventually, you are taken to a place that seems to be more secure. You need time to adjust and trust. You hope that these strangers will help you and be patient as you learn their ways. You may have trouble communicating due to changes in language. You hope they will give you something familiar as you miss your last place. Some days are better than others. Sometimes you really enjoy your new home but sometimes you are very, very sad and miss your old life. Even if the strangers are trying to do everything to make you happy, you still miss your familiar home. You know that this will take time and you hope your new family will have patience and understand that this is hard for you. Now consider that this scenario is repeated several times. Imagine how insecure you might feel. How do you trust? How do you get stability?
It is important for adoptive parents to think about the issues in the aforementioned exercise because they are part of the new child’s transition period. The new child may become argumentative and disagreeable. He/she may withdraw. The child may be happy one moment and very frightened the next. The child is using positive coping mechanisms and will need time to adjust. The new child may manifest both physical and/or emotional reactions. Set realistic limits and be consistent. Your child is probably used to a structured routine and will feel more comfortable with predictability. There has been more limit to this child’s existence so it is easy for him/her to become overwhelmed. If this is the case, simplify the child’s day. It may start with removing some of the myriad of stuffed animals and toys in the child’s room. New parents see it as wonderful and hope to offer their child lots of things to help make up for former deprivation. It may be overwhelming for the child. Don’t plan a big party with all of your closest friends. Be selective whom you bring into the child’s life in the beginning. If you do have strangers in the house, always be within sight or sound of the new child so that they do not feel insecurity about the possibility of another transition. Be the ones to provide food, comfort and care. It will hasten the adjustment period. If the child has too many people to relate to, he/she will not bond as quickly to you. Do not allow your home to become like an orphanage with a constant parade of people flowing through it.
Children in orphanages often have a poor concept of “cause and effect.” Children who have grown up in American families have experienced multiple trips to the store, seen food prepared and served. There is a logical sequence of events. In orphanages, food may just appear. They don’t get to see the transition. It may be difficult for your child to wait for you to shop for the food, cut it up, cook it, and then serve it. Even if they did have to share their caretaker with others, she was not necessarily involved in all of the other daily tasks needed for living. If they have not had the chance to experience the consequences of their behavior or make simple choices for themselves, they may need time and instruction in order to make good choices. Simple choices are first. “Do you want A or B.” This is simple and you as a parent can live with either A or B. You do not need to confuse them with “of course there is also C, D or E.” It may be too difficult for your child to understand. They will need to practice their new skills. A young child may not understand safety concerns as well as his/her peers because they have not been exposed to the stimuli in their new environment. Therefore, those who adopt toddlers or older need to be more cognizant of the safety issues until they are sure the child understands the ramifications of his/her behavior.
Children who have spent considerable time in an institutional setting will have attachments delays and issues. Depending on the child’s background and life experience, the child may recover quickly or may have lifelong attachment disorders. If the child has lacked the opportunity to attach to someone special in their life, the act of attaching to the new family will become much more difficult. While some children seek out and elicit interactions with others, some withdraw from being touched and may not be comfortable in touching others. There are many resources available to families who are experiencing attachment issues. For some, it will be simple and the new child will fit in quickly but with others it will take much more time. Some adopted children experience severe attachment problems and will need significant interventions while others may exhibit symptoms of Reactive Attachment Disorder. Being aware of the impacts of institutional care will aid the adoptive families in making the choices that will ensure the best attachment and bonding experiences possible.
If you observe your child as having difficulty attaching, is withdrawn, resists closeness or touching, cries when held, and/or continually averts eye contact, call an adoption professional immediately. You can improve your child’s chance for “normal” attachment by implementing some attachment exercises. It is very important to develop these skills as quickly as possible.
Some professionals advise that all children who have spent a significant portion of their lives in an institution setting should be treated as “special needs.” What is generally meant by this is that these children need the commitment of extra care. Adoption is often the best “prescription” for these children, but adoption cannot reverse all the problems of early deprivation. If these deprivations have been severe, the child may suffer permanent impairments. Many children thrive in their new families. Unfortunately, no one has the ability to predict with any accuracy the eventual outcome for an individual child. Age is one of the factors affecting adjustment and overall success. Age alone, however, cannot be used as a dependable predictor of success. A baby who has experienced severe deprivation may do worse than a toddler who has had more consistent care and nutrition. Genetics, health, nutrition and care history are as important as age in how the child can make the needed adjustments to family life and a successful life of their own.
The rewards of taking part in helping a child from an institutional setting blossom and thrive are immense. Providing loving care, proper nutrition, good stimulation, and appropriate medical/professional help are essential to making this happen. Being prepared to make the necessary adjustments, being flexible, having a sense of humor, and educating yourself are all necessary parts of achieving the goal of success.
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